A protocol for preventing catheter-associated urinary tract infections: A randomised double-blind crossover study

A protocol for preventing catheter-associated urinary tract infections: A randomised double-blind crossover study

Kate Browne¹, Philip Russo^3,4, Nicole White⁵, Allen Cheng^3,6, Maria Northcote¹, Mark Frydenberg⁴, David Brain⁵, Jacqui Swindells², Peta Tehan³, Brett Mitchell<sup>1,2

1</sup>Avondale University, Cooranbong, NSW, Australia
²Central Coast Local Health District, Gosford, NSW, Australia
³Monash University, Monash, VIC, Australia
⁴Cabrini Health, Melbourne, VIC, Australia
⁵Queensland University of Technology, Brisbane, QLD, Australia
⁶Alfred Health, Melbourne, VIC, Australia











Background
In the community, tens of thousands of people undertake intermittent self-catheterisation to empty their bladders. The frequent use of catheters can lead to complications, including urinary tract infections (UTIs). In Australia, UTIs account for approximately 2% of all GP consultations, highlighting the substantial burden and cost imposed on health services. Yet, little research is available for people who undertake intermittent self-catheterisation in the community. Previous research suggests that using an antiseptic wipe to clean the urethral area can prevent opportunistic bacteria from entering the urinary tract during catheter insertion.

Methods
This study is a double-blind randomized crossover trial spanning 12 months. It will investigate the effectiveness of a chlorhexidine 0.1% wipe in reducing the incidence of UTIs among individuals practicing intermittent catheterization compared to standard practice. Secondary outcomes involve assessing the cost-effectiveness of using antiseptics for meatal cleaning, exploring the personal experiences of participants who engage in intermittent catheterization and the impact of UTIs on quality of life. Each participant will undergo six months in the control phase and six months in the intervention phase, with the allocation randomized among patients.

Results
The study is commencing the recruitment of participants in 2023 and 2024, with results available in 2025. Here we present the methodology of this trial.

Conclusion
The study will provide valuable evidence to inform the insertion practice of people undertaking intermittent catheterisation and potentially funding models. The goal is to reduce the risk of UTIs in a population group that often has existing health challenges.

Biography

Dr Kate Browne is a Postdoctoral Research Fellow at Avondale University and is currently coordinating clinical trials that focus on preventing healthcare-associated infections. Kate has over 6 years of experience working in NSW hospitals, and her research focuses on infection prevention, environmental hygiene, antimicrobial resistance and novel antimicrobial strategies.